NASA psychologist on 'Ad Astra': It takes a superhuman to combat stress

In Ad Astra, Brad Pitt’s character is admired throughout the ranks of U.S. Space Command for his superlative ability to stay calm in harrowing situations. It’s rumored that his heart rate has never risen above 80 beats per minute during a spacewalk.

That skill for stress-management and other aspects of astronauts’ mental and emotional state is explored throughout the contemplative new sci-fi film, as Major Roy McBride (Pitt) completes regular psychological evaluations and comes to terms with how his work as a military astronaut has impacted his personal relationships.

It’s a film that touches on real-life concerns dealt with by NASA’s behavioral health experts — among them, Jim Picano, PhD, who has been a senior operations psychologist at NASA’s Johnson Space Center for five years.

Think about the famous Apollo 13 mission or the time when Canadian astronaut Chris Hadfield was temporarily blinded during a spacewalk — situations like those when things in outer space don’t go as planned (or even when they do) are moments when astronauts must be masters at stress-management — a skill that Picano helps hone.

Picano works with astronauts at all stages of their work for the space agency, from selection through reintegration into life on Earth after a mission. In an interview, he tells Inverse about his work and about Ad Astra and other Hollywood movies — including upcoming film Lucy in the Sky, loosely inspired by the life of NASA astronaut Lisa Nowak, whose troubled return to Earth culminated in her charged with attempted kidnapping. Read on for Picano’s insight on essential skills for astronauts, ideas for missions on Mars, and more.

Inverse: First, tell me what an operational psychologist for NASA does — what does that job title mean?

Jim Picano: Sure, that term may not be familiar to some people because they think of psychologists as the traditional health care providers. As an operations psychologist, our job is working with people who do real-time missions. We are involved in helping to maintain and enhance [astronauts’] behavioral health and well-being and also help to optimize their performance. So we are not dealing with remediation of psychological issues and that sort of thing. Our job is really one of prevention and sustainment and enhancement of psychological health and performance.

I expect you’re closely involved during training.

Exactly. We have sort of a three-tiered approach to our work. Everything we do really has its very beginnings in the selection of personnel for the job. So we are involved pretty significantly in astronaut selection. And then the second piece of that, as you point out, is training. Once we have selected folks for their competencies in the area of the job that we’re involved in, we then get involved in helping to train those competencies and skills. And then we support the astronaut from a behavioral health and performance perspective once they are on orbit or on their mission. That’s the third piece of it. We do also work with reintegration as part of the follow-up to the mission.

While on a mission, are NASA astronauts able to contact you or another psychologist?

We have a couple things that we do. So let me give you a sort of lead-in to that — and by the way, this is not different, if you were to talk to colleagues of mine who are operational psychologists for deploying, mission-critical military units, say, in the special operations community, where you might deploy small teams of people on highly critical and sensitive missions. It’s very much the same kind of process in which we will work with astronauts once they’re assigned to do a flight or to a mission, we’ll work with them. We start about a year and a half out meeting with them to do our pre-flight evaluations and to also engage in training in behavioral health and performance. They’re going through a fair amount of technical training for ISS systems and the payloads they’ll be working with as well as their Soyuz training in Russia. Our training on the non-technical side is geared more toward the skills and competencies that are needed to function effectively as a crew member on the ISS. We start that about a year and a half in advance. We’ll have several meetings over that time period for evaluation. Another handful of meetings for training. And then once they are on-station, we will meet with them or talk with them in something that’s called a private psychological conference every two weeks while they’re on their mission.

The ability to manage stress seems like a key quality of NASA astronauts — how much of that is something that people come in with once they’re selected, and how much is that something you can teach during training?

The way we work is if you can’t train it, you gotta select it. But because it is such a critical skill, we do both. This is a stressful job, and so people who are seen as qualified for the job have to demonstrate that they can tolerate high degrees of stress and still continue to function effectively — and that means without significant performance degradation or changes in their psychological or physical health and well-being. People who are interested in becoming astronauts come from backgrounds in which they have been pretty significantly tested in those areas. They’ve done things like long polar expeditions, or they’ve been on military deployments.

There is an unresolved question — people have this sort of innate ability to tolerate high degrees of stress, so should we only select for it, or can train for it? I think it’s a combination. You can move the needle a little bit with people in training. My preference is to think about it as we try to find people who have already highly developed competencies in the area of stress-tolerance. And then we try to reinforce their stress-coping strategies through training and experience and also education from our end.

The other thing is the training for an astronaut in general or for a specific mission is pretty intense. It’s pretty tough. And in general, again, it’s drawn from military models. Training under realistic scenarios, exposure to the kinds of things you’re likely to face and learning the kinds of skills and abilities it takes to be successful in training brings with it increased self-efficacy. The idea that “I can do this. I have the confidence to be able to do this.” That is, in itself, another stress-buffer. This idea of tough, realistic, high-fidelity training is, in itself, a way of training stress-tolerance.

In Ad Astra, Brad Pitt’s playing a man who’s very good at staying calm in stressful situations, who can compartmentalize well — but he comes to realize that has made him walled off from people in his personal life. Is that kind of thing a concern at NASA?

You can have too much of a good thing when it comes to compartmentalization. It can impact intimate relationships, marriages. And it can impact one on the job as an astronaut as well. Yes, it does keep the emotions at bay. And that’s fine for negative emotions or disruptive emotions. But you can’t distance yourself from all emotion, because that does impact our interpersonal relationships, and it does impact our ability to get along with one another. And the appropriate regulation of emotion is a very important skill. Because another important skill for astronauts is the ability to work well with teams and the ability to get along well with one another in a confined space for a long period of time. That requires emotional competencies — it requires a certain degree of empathy and sensitivity, and that does require an awareness of one’s feelings to be able to use those to be effective interpersonally.

The psych evaluations in Ad Astra are done by artificial intelligence. The private psychological conference you mentioned — is that something you think could be done by A.I. existing either today or in the next century?

I’ll give you my psychologist answer to that. Understand that I’m not threatened in my career by A.I.! I don’t want to sound like I’m being defensive, but here’s the thing: In our work, it requires a high degree of trust between astronauts and us, and it requires that we build a very strong relationship with astronauts. No matter how good any technology is in saying something about the psychological state of the individual and their ability to perform a mission — which I really would question anyway, but let’s say 100, 200 years in the future we have perfected an algorithm that uses big data in a way collected from a human to precisely predict the likelihood of success of a mission — the idea that that would be acceptable to people, to astronauts in particular, or to mission-leaders, mission managers, people who are charged with making these decisions about whether or not to send somebody on a mission — people don’t like giving up agency to machinery, to technology. As humans, agency is so important to us, having our self-determination, that I think it might be a source of information, and it might have a high degree of predictive probability on things, but human decision-making will always be in the loop, and there will be a myriad of factors that determine an individual’s readiness to perform a mission, regardless of what the psychological state is.

Another film I want to ask you about — have you seen The Martian or read the book?

Yes, I’ve seen it.

Do you think that story would have played out differently if Mark Watney, the Matt Damon character, were dealing with anxiety or Major Depression?

Boy, that’s an interesting question.

He’s just such a resilient character, ever-optimistic in the face of needing to survive on Mars alone for what could have been four years.

That exactly speaks to why we want that. We want people who don’t give up in the face of adversity, who continue to look for a solution when it seems on the surface no solution is apparent. The cliche “think outside the box,” to come up with novel solutions to problems that seem unsolvable at the time and not give up. The way I think about it, resilience typically just means the ability to bounce back if you look at the dictionary definition, to come back to its original shape. But resilience to me is more than that — that’s great — but to me, resilience is being stress-tolerant in the way that it takes a high degree of adversity to not get off your feet in the first place. It’s great if you get back on your feet very quickly — but you don’t get knocked off your feet very easily, and when you do, you come back very quickly as well. The idea that you have a lot of capacity, a lot of resources available to you psychologically to draw on during those times when things get really tough out there and it doesn’t bring you down — it doesn’t get you to the point where you give up or your emotional state becomes so affected that it impacts your ability to perform, as in someone who might become depressed and shut down and anxious and unable to focus and work through a problem. So, yes, I do think the outcome would be very different for somebody who did not have that level of stress-resilience, stress-tolerance where they were shutting down and not engaging in the problem and giving up.

For the private psychological conferences that you do, what is the plan for conducting something like those in the future when astronauts are on Mars where (as I understand it), real-time conversations with people on Earth won’t be feasible since sending messages between Earth and Mars will take 20 minutes?

You are correct that our PPCs rely on real-time communications and will not be feasible for astronauts once the communications delay exceeds a certain point in transit to Mars. Though we are not exactly sure what that amount of delay is, we do know that PPCs will not be an effective countermeasure for astronauts on Mars with 40 minute round trip comm delays. We are exploring ways to deal with this — really now in the conceptual phase but with plans by our researchers to look to analog opportunities to test various strategies. For example, in thinking about existing technologies, we can see “store and forward” messages as in tele-medicine applications being one approach. Regardless of the specific technology, there will have to be some change in the way we communicate information such that communications will need to involve more planning and forethought, longer “packages” of information that include greater detail, perhaps anticipating likely responses and follow-ups to limit the back and forth. In short, exactly opposite of the ways we tend to communicate electronically today, with brief back and forth texts or e-mail exchanges. We anticipate that we may also have pre-loaded “interventions” with suggestions for common issues that might be anticipated to arise in individual or crews, as well as a suite of automated psychotherapeutic interventions for more serious problems There is a possibility of having a physician-astronaut, the designated crew medical officer, receive advanced training in some aspects of behavioral health in order to serve as a real-time resource for the crew.

Lucy in the Sky, based loosely on the life of Lisa Nowak, raises questions about astronauts’ return to Earth. Can you tell me more about how you and your colleagues are involved in adjustment to life back on Earth?

We begin that discussion with our astronauts in our private psychological conferences toward the end of their mission. Obviously, it depends on the kind of mission. Our folks need to be mission-focused, and they need to have their heads on the station, if you will, rather than on the ground with us. If there are critical operations toward the end of a mission, such as a spacewalk or a vehicle capture or something like that, that involves operational focus, and we don’t want to take that astronaut’s focus away from critical mission activities. But generally speaking, within the last month or so of a long-duration mission, we might start raising the idea of coming back home in our discussions.

About 40 percent or so of our astronauts have a military background, and many of them have experienced deployment and know what it’s like to come back into the family and come back to work after being on a deployment. So sometimes, we’re just reinforcing something they’ve already done effectively and know about. Sometimes we’re breaking new ground with some of our scientist astronauts.

So about a month in advance, we’ll start bringing up the topic, ask that they start thinking about it, start having those conversations with family. There are a lot of things that we do to support crew members in communication with their family. After they return back to Houston, we meet with them three days after return, 14 days after return, and then again, 30 days after return. So we have three meetings with them in which we will work on — in addition to other things — family and work reintegration. There’s also ‘what’s next?’ What’s next in the career? What are your thoughts about where you go from here? Some astronauts will face career choices after a flight depending on how long they’ve been an astronaut, how old they are, things like that.

For Lisa Nowak, the attempted kidnapping incident happened several months after she returned from space. Did that prompt any changes with how you interact with astronauts further out than the 30 days you mentioned?

Oh, yes, And thank you for bringing that up, because one of the things that was a change in the way we work — sort of a realization that there was a gap in our work, in that we had a lot of contact with astronauts during selection in their initial training and then not again until their flight status. As a result of that gap — and that was part of a whole look at how we work post the Lisa Nowak incident — what has come from that was an annual contact with astronauts. We call it an “annual,” “BHP annual” where they sit down with our BHP [Behavioral Health and Performance] psychiatrist and they just sort of talk about what’s going on. It sort of focuses on work and family life. It’s another touch-point for us so we keep involved in what’s current with our astronauts. That was not happening before. I was not here at the time of the Nowak incident, so I really can’t speak more to that. Some things are just unpredictable. We never claim that we can predict anything. But I do think having closer ties to the astronauts, having that opportunity to have multiple touch-points with them improves our relationship with them — they’re more forefront in their thinking about “hey, maybe we should go run this by the BHP folks.” It’s the model that’s more typical in operational environments in which there’s a better integration with the operational behavioral health folks — we’re not clinic personnel that you go see when you have a problem. We’re there as resources in everyday interactions. We are closer to that model now post-Lisa Nowak than pre-Lisa Nowak.

Finally, I’d like to hear from your what your advice is for anyone who aspires to be an astronaut — what are your recommendations for honing these kinds of non-technical skills we’ve been talking about?

I think the skills that are needed for astronauts are good life skills for everybody. We have to live and work effectively with others. Think about team skills — those are really important competencies. Scott Kelly says in his book that “spaceflight is the biggest team sport.” For every one astronaut, there are dozens of teams behind that individual, supporting that individuals work on a daily basis. An astronaut’s community on board the Station is very close quarters and the same people — an isolated, confined community, where there’s a premium on getting along with one another, being tolerant of each other’s differences, respecting each other’s personal space, their needs, their psychological needs, being a good roommate, if you will. So having opportunities to develop those kinds of competencies, whether it’s in team sports or other aspects of communal living, like dormitory living, other opportunities that develop those kind of skills — they’re good for not only becoming an astronaut if you have that aspiration but in being a good work-mate and a good, civic-minded neighbor.

I will also say the thing you hear a lot of astronauts say when they’re asked that question, and that is, find something you are passionate about, and do it well. Because the odds of making it to an astronaut are fairly low. So if you are working toward something you are passionate about and highly committed to and enjoy doing, and you do it very, very well, if you miss the mark of becoming an astronaut, you’ll still have a very enjoyable and productive life. Obviously, it has to be related to what we’re interested in — this idea of STEM. That’s the technical side of it. But from the non-technical side of it, I think about those interpersonal skills, the teamwork skills, and the small group living skills as being critical, especially for long-duration space exploration missions that are hopefully in our future, like Mars.

This interview has been edited for length and clarity.